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Current evidence regarding the benefits of Whole-Body Vibration (WBV) on postural stability and jump performance remains inconsistent and to the best of our knowledge, there is no study comparing the effectiveness of different vibration frequencies on trunk muscle strength. This study was conducted to determine the effect of whole-body vibration training with different vibration frequency on isokinetic trunk muscle strength, postural stability and jump performance in physically inactive and minimally active healthy female adults. Forty-five females were randomly assigned to 45 hz WBV group (n = 15), 25 hz WBV (n = 15) group and control exercise group without WBV (0 hz group, n = 15). Individuals in each group completed a 6-week trunk-based exercise program at the specified vibration frequency. Concentric and eccentric strength of trunk flexor and extensor muscles, postural stability and jump performance were assessed before and after the training period. There were significant group by time interactions in concentric and eccentric trunk muscle strength. Interaction effects showed no significant differences in postural stability and vertical jump performance. However, post hoc analyses revealed that all three groups significantly improved vertical jump height. These findings suggest that WBV combined with exercise training were effective to enhance the strength of trunk muscles in physically inactive and minimally active women. Nevertheless, WBV exercise training performed in this study had no significant impact on postural stability and jump performance.Clinical Trials Number: NCT05014958 (Pre-registired) [ABSTRACT FROM AUTHOR]

ABSTRACT Objective The rehabilitation methods after total knee arthroplasty (TKA) can affect the recovery of complications and joint function, and the selection and comparison of rehabilitation methods after TKA still need further research. Methods A comprehensive search of five databases and two clinical trial registration platforms was conducted from inception through March 31, 2024, and conducted to identify eligible randomized controlled trials (RCTs). We extracted the required data according to the Cochrane Handbook for Systematic Reviews of Interventions. Finally, 32 trials involving 2292 patients were included, the mean age of the enrolled patients was ~69.10 years, the sex ratio of males was (31.6%), and the longest follow‐up time was 2 years. And we have summarized nine rehabilitation intervention measures: conventional physical therapy (CPT), cryotherapy, thermal therapy (TT), acupuncture, hydrotherapy, neuromuscular training (NT), electrotherapy, continuous passive motion (CPM), continuous active motion (CAM). And use the range of motion (ROM), visual analog scale (VAS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC) as the outcome measure to evaluate the effectiveness of various interventions. A Bayesian network meta‐analysis (NMA) was carried out for calculating standardized mean difference (SMD) and the surface under cumulative ranking curve (SUCRA) of improvement of knee joint function after TKA by different rehabilitation methods. Result After treatment, the ROM results showed that cryotherapy, electrotherapy, and NT had better therapeutic effects. Among them, cryotherapy (WMD = 10.3, 95% CI 1.63–18.2) had a significant therapeutic effect. In terms of VAS, NT and TT showed good therapeutic effects. Among them, NT had a more significant therapeutic effect, while CAM had less effect. After treatment, in terms of WOMAC, TT, hydrotherapy, cryotherapy, and NT had better therapeutic effects. TT had the best therapeutic effect, while Hydrotherapy and Cryotherapy also had certain advantages. Conclusion NT, TT, cryotherapy, hydrotherapy, and electrotherapy rehabilitation therapies have good therapeutic effects for TKA patients compared with other interventions. Among them, NT may be the best postoperative rehabilitation therapy.

Background. Football players require high levels of speed and explosive power to perform effectively on the field, making these physical attributes critical for success. Neuromuscular training has been proposed as a method to enhance these performance metrics. Objectives. The purpose of the present study was to examine the effect of neuromuscular training on the speed and explosive power performance of football players. Materials and methods. A total of thirty male football players (aged 20 to 26 years) from Imphal West District, Imphal, Manipur, India, who had participated in national-level competitions, were selected for the study. The subjects were randomly assigned into two equal groups: an experimental group (n = 15) and a control group (n = 15). Both groups were assessed before the intervention for speed and explosive power performance using the 50 m dash speed test and the standing broad jump test to determine the baseline significance of the selected variables. Following the initial assessments, the experimental group underwent a supervised neuromuscular training program, while the control groupreceived no special training. The neuromuscular training was conducted over a period of six weeks, with sessions held five days a week (Monday to Friday), each lasting 60 minutes. Results. The experimental group confirmed significant improvements in both speed and explosive power compared to the control group (p

Supplemental Digital Content is Available in the Text. Poulios, A, Fotiou, C, Draganidis, D, Avloniti, A, Rosvoglou, A, Batrakoulis, A, Tsimeas, P, Papanikolaou, K, Deli, CK, Stampoulis, T, Douroudos, II, Chatzinikolaou, A, Jamurtas, AZ, and Fatouros, IG. The energy expenditure associated with body-weight resistance exercises of various movement patterns performed at different durations. J Strength Cond Res 38(12): 2034–2046, 2024—Although body-weight resistance exercises (BWRE) are popular and effective for body mass reduction and neuromuscular performance, limited information exists regarding their total energy expenditure (TEE). This study determined the energy cost associated with seven BWRE of different movement patterns plank, push-ups, squat, single-leg squat [SLS], forward lunge [FL], burpees, and jumping jacks [JJ] using 2 different durations (T30: 30-second; T45: 45-second) in 10 healthy young adults using a randomized, 2-trial, crossover, repeated-measures design. The level of significance was set at p ≤ 0.05. The burpees were associated with the highest and the plank with the lowest intensity (rates of perceived exertion [RPE] and mean heart rate [MHR]) and metabolic load (blood lactate [BL] accumulation, metabolic equivalents of task [METs], and excess post-exercise oxygen consumption [EPOC]) in both trials. In T30 and T45, TEE (kcals per minute) was 11.3/12.6 in plank, 18.6/22.0 in FL, 19.8/21.2 in SLS, 19.9/23.2 in squat, 22.0/24.9 in push-ups, 23.1/22.8 in JJ, and 32.2/40.7 in burpees. Although RPE, MHR, BL, and EPOC were comparable among T30 and T45, METs and TEE were greater in T45. These results suggest that TEE of BWRE ranges from ∼11 to 40 kcals·min−1, depending on the movement pattern and the duration of exercise. This information may be valuable for those using BWRE for body-weight management and improvement of strength performance. [ABSTRACT FROM AUTHOR]

Background: Physical literacy and injury prevention strategies use similar movement-related constructs and can be connected to develop comprehensive interventions. We aimed to test the feasibility and effects of a neuromuscular warm-up based on physical literacy and injury prevention strategies for 8–12-year-old children. Methods: We conducted a cluster non-randomized controlled trial. We defined a priori feasibility criteria and studied the effects of the intervention on physical literacy constructs, movement competence, and neuromuscular performance. We used generalized linear mixed models controlling for covariates and clustering with a significance level of 0.001. Results: We recruited 18 groups (n = 363) and randomly allocated nine to intervention (n = 179; female = 63.7%, age = 9.8 ± 1 years) and nine to control (n = 184, female = 53.3%, age = 9.9 ± 0.9 years). We met four of seven feasibility criteria (i.e. recruitment, adherence, enjoyment, perceived exertion). The three feasibility criteria that were not met (i.e. compliance, fidelity, follow-up) were slightly below the predefined threshold (90%). Model-adjusted mean differences for physical literacy constructs, movement competence, vertical jump height, horizontal jump distance, 20-m sprint time, and dynamic balance favored the intervention (p <.001). Conclusion: The feasibility evidence indicates that the intervention should be slightly modified before implementing it in a larger study. The observed mean differences are promising and can be used in planning future interventions. [ABSTRACT FROM AUTHOR]

Background: Aging causes morphological and physiological changes, especially in the musculoskeletal and somatosensory systems, leading to sarcopenia and reduced postural balance, increasing the risk of falls and loss of independence. This study aimed to analyze the effects of a neuromuscular training program on postural balance, physical performance, and muscle strength in older Chilean women. Methods: The double-blind randomized controlled trial included 48 participants aged 65–80 who were divided into three groups: a control group (CG), a multicomponent training group (MCG), and a neuromuscular training group (NMG). Postural balance was assessed using a force platform with open eyes (OE) and closed eyes (CE) conditions, measuring ML velocity, AP velocity, mean radius, and area. Physical performance was evaluated with the Short Physical Performance Battery (SPPB), including static balance, 4-m walking speed, and 5× sit-to-stand chair test. Muscle strength was measured using a hydraulic hand dynamometer to record maximum grip force. Results: Significant time × group interactions in the CE condition were found for mean radius (F = 0.984; p = 0.017; ηp2 = 0.184), AP velocity (F = 10.01; p = 0.001; ηp2 = 0.312), and ML velocity (F = 4.30; p = 0.027; ηp2 = 0.163). Significant pre–post differences in the NMG for mean radius (p < 0.001), AP velocity (p < 0.001), and ML velocity (p = 0.029) were observed, with no significant changes in CG. Significant time × group interactions were also found in the SPPB test score (F = 11.49; p < 0.001; ηp2 = 0.343), gait speed (F = 5.513; p = 0.012; ηp2 = 0.198), and sit-to-stand test (F = 5.731; p = 0.010; ηp2 = 0.206), but not in the balance score (F = 2.099; p = 0.148). Handgrip strength showed no significant interactions (F = 3.216; p = 0.061; ηp2 = 0.127). Conclusions: These findings suggest that neuromuscular training is a promising intervention to mitigate the decline in balance and physical function associated with aging, offering a targeted approach to improve the quality of life in the elderly. [ABSTRACT FROM AUTHOR]

Background: Subacromial balloon spacer implantation (SBSI) attempts to decrease glenohumeral joint (GHJ) pain and improve function in patients with an irreparable rotator cuff tear (RCT) and minimal osteoarthritis. Between 12 and 26 weeks post-SBSI, gradual implant resorption may create a "balloon dip" that decreases GHJ function and increases pain. This retrospective cohort study attempted to delineate shoulder function, active mobility, strength, pain, and functional task impairment during the "balloon dip" period. Materials and methods: Sixty-five consecutive patients (55.9 ± 7 years of age, 42 men) with an irreparable RCT treated by the same fellowship-trained shoulder surgeon participated in this study. Outcome measurements pre-SBSI, during Phase I (early pain control ≤ 3 weeks post-SBSI), Phase II (early rehabilitation > 3–11 weeks post-SBSI), Phase III (advanced rehabilitation-early balloon resorption > 11–16 weeks post-SBSI), Phase IV (early strength training > 16–24 weeks post-SBSI), and Phase V (advanced strength training > 24 weeks post-SBSI) included the American Shoulder and Elbow Society (ASES) score for perceived bilateral shoulder function, visual analog scale (VAS) surgical shoulder pain score, active mobility, and shoulder manual muscle strength testing (p ≤ 0.05). Results: The mean final follow-up time was 40 weeks (range = 24.1–89.7 weeks). The surgical shoulder had higher ASES scores at Phase V than pre-SBSI. Surgical shoulder pain was less during Phase V than pre-SBSI. The surgical shoulder had greater flexion during Phase V than at Phase II or pre-SBSI, and greater external rotation (adducted) during Phases V-III than pre-SBSI. Peak shoulder internal rotation to level 12 (thoracic spinous process #10) occurred during Phase V. Peak shoulder flexor, external rotator, and internal rotator strength occurred during Phase V. During Phase I, most subjects were unable to sleep on their surgical shoulder, wash their back/do up their bra, reach a high shelf, or lift 10-lbs overhead. Tasks that were impaired during the "balloon dip" (between Phase III and V) were lifting 10-lbs overhead, reaching a high shelf, and doing normal work. By the end of Phase V, however, most subjects could perform each task with minimal or no difficulty. Conclusion: Surgical shoulder function improved and pain decreased, however, specific perceived functional task impairments remained. During the "balloon dip" phase, the perceived ability to lift 10 lbs above shoulder level, to reach a high shelf, and to do usual work activities were the most impaired tasks. [ABSTRACT FROM AUTHOR]

• fMRI bilateral motor control task was used to evaluate longitudinal changes in brain activity. • Neuromuscular training induced movement adaptations in MC and HxSRC groups. • MCs demonstrate increased cerebellar activity associated with improved frontal plane ROM. • HxSRCs demonstrate increased somatosensory activity associated with improved frontal plane ROM. Sports-related concussion (SRC) in adolescent athletes is associated with an increased risk of subsequent lower extremity injury. Neuromuscular training (NMT) has shown promise for reducing lower extremity injuries following SRC, however, neural adaptations in response to changes in lower extremity biomechanics following NMT in athletes with a history of SRC (HxSRC) remains poorly understood. Therefore, the purpose of this study was to identify changes in neural activity associated with lower extremity movement adaptations following a six-week NMT intervention in athletes with a HxSRC. Thirty-two right-hand/foot-dominant female adolescent athletes (16 with self-reported HxSRC, 16 age- and anthropometrically-matched controls) completed a bilateral leg press task with 3D motion analysis during functional magnetic resonance imaging (fMRI). Movement adaptations were defined as a change in frontal and sagittal plane range of motion (ROM) during the fMRI bilateral leg press task. Significant pre- to post-NMT reductions were observed in the non-dominant (left) mean frontal plane ROM. Whole-brain neural correlate analysis revealed that increased cerebellar activity was significantly associated with reduced mean left-knee frontal ROM for matched controls. Exploratory within group analyses identified neural correlates in the postcentral gyrus for the HxSRC group which was associated with reduced mean left-knee frontal plane ROM. These distinct longitudinal changes provide preliminary evidence of differential neural activity associated with NMT to support knee frontal plane control in athletes with and without a HxSRC. [ABSTRACT FROM AUTHOR]

Background. Football players require high levels of speed and explosive power to perform effectively on the field, making these physical attributes critical for success. Neuromuscular training has been proposed as a method to enhance these performance metrics. Objectives. The purpose of the present study was to examine the effect of neuromuscular training on the speed and explosive power performance of football players. Materials and methods. A total of thirty male football players (aged 20 to 26 years) from Imphal West District, Imphal, Manipur, India, who had participated in national-level competitions, were selected for the study. The subjects were randomly assigned into two equal groups: an experimental group (n = 15) and a control group (n = 15). Both groups were assessed before the intervention for speed and explosive power performance using the 50 m dash speed test and the standing broad jump test to determine the baseline significance of the selected variables. Following the initial assessments, the experimental group underwent a supervised neuromuscular training program, while the control group received no special training. The neuromuscular training was conducted over a period of six weeks, with sessions held five days a week (Monday to Friday), each lasting 60 minutes. Results. The experimental group confirmed significant improvements in both speed and explosive power compared to the control group (p < 0.05). The mean and standard deviation of speed for the experimental group were 7.15 ± 0.71 in the pre-test and 6.54 ± 0.61 in the post-test. For explosive power, the values were 2.36 ± 0.32 in the pre-test and 2.55 ± 0.39 in the post-test. The notable enhancements in speed and explosive power performance in the experimental group are likely attributed to the six-week neuromuscular training program, which facilitated rapid physical adaptation among the football players. Conclusions. Implementing the six-week neuromuscular training program effectively enhanced the speed and explosive power performance of football players. This type of training has been demonstrated to be highly effective for optimizing these performance metrics in football players. [ABSTRACT FROM AUTHOR]

Introduction Team sports have become increasingly fast-paced and athletic, particularly at the elite international level. Over the past 15 years, a widening performance gap in explosiveness and speed has been observed between Swiss youth and elite athletes in team sports. Promising talents with deficits in these areas face growing difficulties in establishing themselves at the elite level. Concurrently, there has been a rapid increase in scientific publications demonstrating the positive effects of neuromuscular training on explosiveness, speed, and in addition on injury prevention. Objective: To develop an evidence-based educational program for coaches to optimize neuromuscular training in youth team sports, addressing the challenges of complex knowledge transfer, diverse stakeholders, and heterogeneous training approaches. Methods The "Power to Win" project was initiated by the Swiss Federal Institute of Sport Magglingen in collaboration with Swiss national sports federations and Swiss Olympic. A multi-step approach was employed: • Formation of a project group comprising scientists, practitioners, and stakeholders • Development of an impact model focusing on optimizing athlete training through improved coach knowledge, awareness, and motivation. • Analysis of training content, coach knowledge, and educational courses. • Creation of a roadmap based on scientific evidence and expert knowledge. • Definition of key concepts and models (e.g., performance model, long-term athlete development model). • Structuring of knowledge according to educational levels (Jugend+Sport, national federations, coach education) and along the talent pathway (FTEM model, F1 to T4). • Stage-specific adaptation of knowledge transfer considering available time for education and existing knowledge. Results The project resulted in the development of five digital learning courses for self-study and for integration into existing training programs. These courses are freely accessible online and designed to facilitate blended learning approaches, allowing for increased practical training time during in-person courses. The online content covers Bloom's taxonomy levels 1-3, while levels 4-6 are addressed in face-to-face training sessions. Discussion/Conclusion Translating scientific evidence into practical applications presents significant challenges due to various external influences. This project demonstrates a systematic approach to developing an evidence-based educational program for neuromuscular training in youth team sports. By addressing the complexities of knowledge transfer and considering the needs of diverse stakeholders, this program aims to bridge the gap between research and practice in enhancing performance and preventing injuries among young athletes in team sports. Future research should evaluate the effectiveness of this educational program in improving coach knowledge and behavior, as well as its impact on athlete performance and injury rates in youth team sports. References Coutts, A. J. (2017). Challenges in developing evidence-based practice in high-performance sport. International Journal of Sports Physiology and Performance, 12(6), 717–718. https://doi.org/10.1123/IJSPP.2017-0455 Lloyd, R. S., Oliver, J. L., Faigenbaum, A. D., Howard, R., De Ste Croix, M. B., Williams, C. A., Best, T. M., Alvar, B. A., Micheli, L. J., Thomas, D. P., Hatfield, D. L., Cronin, J. B., & Myer, G. D. (2015). Long-term athletic development, part 2: Barriers to success and potential solutions. Journal of Strength and Conditioning Research, 29(5), 1451–1464. https://doi.org/10.1519/01.JSC.0000465424.75389.56

Introduction The practical application of scientific knowledge is essential for improving performance in Olympic air rifle shooting. At the Swiss Shooting Federation, for example, we have implemented an innovative training concept based on our research into compensation-sensitive shot styles and the importance of individual movement phases (Tartaruga & Kredel, 2021, 2022, 2024). Methods We have been collecting SCATT training sessions from athletes via email and utilizing a MATLAB script that waits for and automatically analyses incoming data. The analysis is performed according to the methods proposed in our study, including the use of a validated movement phase segmentation algorithm of aiming point trajectory data and the identification of compensation-sensitive shot styles based on this data. We consider athlete-specific preferences and compare current data with results from the last ten years to provide a social and normative reference orientation. Results Through individualised analysis of shooting data, coaches can develop tailored training plans that address the specific needs of each athlete and receive immediate feedback on the technical impact of recent training sessions on different technical characteristics. Comparison of historical data also provides valuable insight into performance development across disciplines, gender, and age for specific technical characteristics. These insights are used to optimize coaches’ education programs by providing a generalised understanding of the technical development of young athletes in shooting. Furthermore, some technical characteristics even have predictive validity for real shooting performance and therefore appear to be suitable for talent identification. Discussion/Conclusion The integration of compensation-sensitive shot-styles and the consideration of individual preferences have led to a higher acceptance of the tailored feedback reports than the previous more generalised reports. In the future, we plan to extend these approaches by applying them to other disciplines within the shooting sports. In addition, we would like to scientifically validate specific training interventions to promote successful shot styles, with the aim to provide evidence-based training recommendations in the future. In our view, this project serves as a good example of how challenging real-world problems brought up by coaches and embedded scientists can be jointly structured and solved at federation and university level, and how their solution can ultimately lead to practical tools reshaping and improving a federation’s process landscape. References Tartaruga, D., & Kredel, R. (2021). Prognose der Wettkampfleistung anhand von Techniktests im olympischen Luftgewehrschiessen [Prediction of competition performance based on technical tests in Olympic air rifle shooting]. Magglinger Trainertagung, 10. https://www.swissolympic.ch/dam/jcr:26fcf124-ce21-4b1f-9abb-bb5caf3f7011/Book_of_Posters_2021_A4h_def.pdf Tartaruga, D., & Kredel, R. (2022, March 29). Shooting styles in Olympic air-rifle shooting. 25. Sportwissenschaftlicher Hochschultag der Deutschen Vereinigung für Sportwissenschaft: Sport, Meer & Mehr – Sportwissenschaft in gesellschaftlicher Verantwortung, Online (Kiel). https://doi.org/10.48350/169324 Tartaruga, D., & Kredel, R. (2024). Effects of inter- and intraindividual compensation-sensitive shot styles on performance in Olympic air rifle shooting. Current Issues in Sport Science (CISS), 9(1), Article 006. https://doi.org/10.36950/2024.9ciss006

Background: Adolescent tennis players encounter critical physical demands, but the lack of comprehensive analysis of training types hampers the selection of optimal training programs. This study aims to conduct a systematic literature review to analyze the effectiveness and limitations of various training types on the physical demands of adolescent tennis players, summarizing the optimal training methods to enhance these physical qualities. Methods: From March 2024, a comprehensive search was conducted across four electronic databases: SCOPUS, PubMed, EBSCOhost (SPORTDiscus), and Web of Science. Additionally, Google Scholar and other sources of gray literature were referenced. Original research articles with an experimental design were included. The methodological quality of the included studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale, and the overall scientific evidence was determined through the best evidence synthesis (BES). Results: Eighteen articles on exercise training met all inclusion criteria and were included in this systematic review. These studies maintained a high standard of quality, making their findings relatively credible. Among them, five studies investigated plyometric training, five focused on neuromuscular training, three explored functional training, two examined traditional strength training, and three assessed High-Intensity Interval Training. Conclusion: To enhance speed, strength, power, agility, and dynamic balance, it is recommended to prioritize plyometric training, neuromuscular training, and functional training over traditional tennis training. Functional training is particularly effective for improving flexibility and balance, while plyometric training is more suited for increasing power and speed. Neuromuscular training, when performed before routine workouts, is beneficial for enhancing speed, flexibility, and strength. Hard surface training is ideal for boosting power, whereas sand training excels in improving strength, speed, and balance. Combining HIIT with strength training is especially advantageous for enhancing short-distance sprinting, repeated sprint ability, and power. By appropriately combining and utilizing these training methods, the physical capabilities and sports performance of adolescent tennis players can be comprehensively optimized. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42024578147. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the awareness and knowledge of professional team sport athletes about ACL injuries, injury prevention programs, and the return to sports after ACL injuries. A total of 419 athletes representing soccer, basketball, volleyball and handball sports were included in the study. We utilized a 15-item self-report survey to assess the awareness of athletes about ACL injury, ACL injury prevention program, and return to sport after ACL injuries. Male and soccer players participated in prevention programs more than female athletes (p = 0.001). Participation in prevention programs was significantly higher in the ≥ 18 years old group than in the < 18 years old group (p = 0.040). Participants who were informed about ACL injuries were 8.4 times more likely to participate in the ACL injuries prevention program than others (OR: 8.38, 95% CI: 3.823–18.376, p < 0.001). The majority of participants believed that return to sport after ACL injury takes 6 months and 81.4% of them thought that it is not possible to do sport without an ACL. This study revealed that the awareness and performance of ACL prevention training programs among professional team sport athletes were insufficient. The athletes' knowledge regarding return to sports after ACL injuries was also inadequate. Improving athletes' knowledge of ACL injuries may lead to increased participation in ACL injury prevention programs. Thus, the provision of tailored educational interventions to athletes could potentially enhance their awareness and understanding of ACL injuries, consequently contributing towards the prevention of such injuries. [ABSTRACT FROM AUTHOR]

This study set out to evaluate the efficacy of NT in mitigating the risk of the students and other sportsmen and women of collegiate and amateur soccer, basketball, and volleyball teams with sports injuries. The study design used was a randomized controlled trial with 100 participants, 50 males and 50 females aged between 18 and 35 years. The subjects were divided into the NT group, which exercised three times a week for 12 weeks with NT, and the control group, which trained as they usually did. The main objective was to capture the number of lower limb injuries and the secondary objectives involved capturing joint stability, proprioception, and functional performance. The NT group had a 12% incidence of injury while the control had a 30% incidence; chi-square = 8.43, p = 0.004. Further, the NT group recorded significant changes in joint stability, as measured by the anterior drawer test (p < 0.001) and proprioception using a balance board (p < 0.001). In addition, functional performance measures such as the vertical jump height, agility, and one-rep max squat all improved significantly (p < 0.001). Hence, the study shows that the assimilation of NT in athletic training could help prevent acts of injuries and propel the performance of athletes. [ABSTRACT FROM AUTHOR]

Background: Neurofeedback training (NFT) can aid in the treatment of the abnormal patterns of the brain brought on by physical injury, enhancing cognitive and behavioral abilities. The present study aimed to compare the effectiveness of combining neuromuscular training (NMT) and NFT (NMT+NFT) with NMT alone in rehabilitating athletes with chronic ankle instability (CAI). Hypothesis: NMT+NFT will be more effective than NMT alone. Study Design: A 3-arm, single-blind randomized controlled trial. Level of Evidence: Level 2. Methods: A total number of 62 athletes, aged 18 to 25 years, with CAI, participated in this study. The study subjects were allocated randomly to 3 groups: 21 cases in the control group, 21 cases in the combination group (CG) receiving NMT+NFT, and 20 cases in the neuromuscular group (NG) practicing NMT alone, undergoing exercises related to their groups for 8 weeks. Data were recorded and analyzed before and after the 8-week training program. The primary outcome measures were postural sway indices; secondary outcomes included ankle proprioception and biopsychosocial indices. Results: NMT+NFT was more effective than NMT alone in terms of improving postural control during single- and 2-legged standing positions under the conditions of eyes closed and eyes open, proprioception at 20° of plantar flexion, as well as anxiety and depression in athletes with CAI. However, the findings revealed that NMT+NFT and NMT alone could both improve such indices. Conclusion: NMT+NFT as a treatment protocol improved postural control, ankle proprioception, anxiety, and depression greater than NMT alone. Clinical Relevance: A combined protocol of NFT and NMT led to greater improvement compared with NMT alone. NFT was recommended as an adjunct therapy in the rehabilitation of athletes suffering from CAI. [ABSTRACT FROM AUTHOR]

Background: Neuromuscular training (NMT) programs delivered by trained personnel have demonstrated protective effects against anterior cruciate ligament (ACL) injury among high school sports participants, but few studies have investigated the impact of education on high school sports coaches' knowledge and incorporation of NMT programs into daily practice sessions. Purpose: We sought to evaluate changes in knowledge and behavior among high school sports coaches who completed an NMT-based injury prevention training program. Methods: High school sports coaches were invited to complete a free online training course in incorporating NMT into daily practice sessions. Anonymized surveys were administered before and after education and at 3 months to evaluate knowledge level and program effectiveness. Results: Of the 13,640 coaches who enrolled in the training course in 2019, 1641 submitted pre- and post-education and 3-month follow-up surveys. Prior to training, 4.4% reported incorporating NMT into daily training sessions and the mean knowledge score was 1.89 ± 1.55. After training, 92.7% of participants reported that they intended to incorporate NMT into their daily training sessions and the mean knowledge score was 4.87 ± 1.11. At 3-month follow-up, 88.9% of participants reported incorporating NMT into daily training sessions. A chi-square test revealed a significant association between pre- and post-education incorporation of NMT into daily practice sessions, and a multiple regression analysis resulted in a significant model with intent to incorporate NMT into daily practice sessions identified as a significant behavior predictor. Conclusion: These survey results show that completion of a training course significantly improved ACL injury prevention knowledge among a cohort of high school sports coaches and likely contributed to the sustained incorporation of NMT into their daily practice sessions. [ABSTRACT FROM AUTHOR]

To address the increasing rates of anterior cruciate ligament (ACL) injury among young sports participants, the Hospital for Special Surgery (HSS) and the Aspen Institute convened a meeting of a new national coalition to make ACL injury prevention a fundamental aspect of youth sports. This executive summary outlines the National ACL Injury Coalition's goals as defined at its inaugural meeting held at HSS on March 27, 2023. Using a theory of change called "collective impact" designed to support collaboration and drive systems-level change, the coalition focused on 4 strategic priorities intended to reduce ACL injury rates in high school sports participants: widespread implementation of interventions (ensuring that student athletes are adequately trained), high-quality education (raising awareness among many stakeholders), equitable access (ensuring that all high school sports participants, regardless of the resources available at their schools, have access to injury prevention resources), and aligning stakeholders (uniting disparate entities—schools, sports clubs, parents, coaches, and others in these efforts). The group outlined short-range, medium-range, and long-range goals over a 3-year period, including the launch of an ACL injury prevention toolkit for use by adolescent sports participants and teams, athletic trainers, coaches, and other key stakeholders. [ABSTRACT FROM AUTHOR]

People with intellectual disabilities have a reduced level of physical fitness. Institutionalization may be one of the important factors associated with their lower level of physical activity. Implementing a training intervention for institutionalized adults with intellectual disabilities requires an innovative and individually tailored approach that may differ from the approach for the general population. This study aims to determine the effects of a newly designed exercise training programme, consisting of neuromuscular exercises and outdoor walking training, on muscular endurance, power, and balance of institutionalized adults with intellectual disabilities. The participants were 90 institutionalized adults (43.9 ± 9.0 years), with mild to moderate intellectual disabilities, randomly assigned into a control (n=45) or an experimental group (n=45). The experimental group participated in the experimental training programme for 12 weeks (60 training sessions). In the experimental group, participants' muscular endurance (p=.01) and power (p=.04) were significantly improved without major changes in balance. The latter was probably due to a small amount of specific postural exercises in the applied combined exercise programme. Future research should focus on finding an appropriate volume of postural control exercises to stimulate balance improvement in this specific population. [ABSTRACT FROM AUTHOR]

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Neuromuscular training improves neuromuscular control and balance, consequently enhancing joint stability. This study aims to assess the impact of a structured neuromuscular training program on balance and performance among university amateur male futsal team players and to analyze biomechanical factors pertinent to injury risk assessments. Thirty athletes aged between 18 and 25, participating in the university male futsal team, will be enrolled in this study. At the outset, all athletes will undergo evaluation using the Korebalance® System, Countermovement Jump, Running-Based Anaerobic Sprint Test, Shot on Goal Test, Sit and Reach Test, Shuttle, Y Balance-Lower Quadrant, and The Tuck Jump test. Subsequently, they will maintain their regular training regimen of classical training twice a week for eight weeks and undergo reassessment using the same battery of tests after 8 weeks of period. Following this initial phase, the athletes will be randomly assigned to two groups: Control Group (n = 15) and Neuromuscular Training Group (n = 15). The Control Group (CG) will continue with their classical futsal training twice a week for eight weeks, while the Neuromuscular Training Group (NMEG) will engage in progressive structured neuromuscular training in addition to their regular futsal training, also twice a week for eight weeks. At the conclusion of the eight-week intervention period, both groups will undergo reevaluation using the same assessment methods. The study commenced in October 2023 and is anticipated to conclude by August 2024. It is anticipated that the integration of progressive structured neuromuscular training into futsal team training programs will yield positive outcomes. [ABSTRACT FROM AUTHOR]

Objective: Neuromuscular training is a relatively new comprehensive rehabilitation treatment method in recent years. Although its preventive effect on adolescent sports injuries is indisputable, its specific effects on gender, injury site, and type are still poorly understood. This study evaluated the clinical efficacy of neuromuscular training on adolescents of different genders, injury sites, and types through systematic meta-analysis. Method: A comprehensive search was conducted on clinical randomized controlled trials related to the prevention of adolescent sports injuries through neuromuscular training in databases such as PubMed, Web of Science, EBSCO, and Scopus. The databases were established until May 2024. The neuromuscular training group (experimental group) used neuromuscular training or neuromuscular training as the main intervention method; The control group is either a blank group or a routine exercise group, without paying special attention to neuromuscular control. Outcome measures include any form of muscle, ligament, or bone injury, including acute or chronic injury data. The quality of the included literature was determined using the Cochrane bias risk assessment tool and the physical therapy evidence database scale, and statistical analysis was conducted using RevMan 5.4 and Stata 16.0 software.This study is registered with the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY), INPLASY2024110054. Result: A total of 32 clinical randomized controlled trials were included, with a sample size of 34581 cases. The meta-analysis results showed that: 1. The overall effect of neuromuscular training: the experimental group was better than the control group, with a combined IRR of 0.67 (95% CI2 0.57-0.79); Z = 4.78;P < 0.00001). The male group had a higher risk of loss compared to females in the experiment; 2. Upper limb motor injury: combined IRR of 0.73 (95% CI2 0.59-0.9); Z = 3.12;P =0.002). The male group had a lower risk of injury compared to females in the experiment. 3. Lower limb motor injury: combined IRR of 0.66 (95% CI2 0.56-0.77); Z = 5.12;P< 0.00001). The male group had a higher risk of loss compared to the female group in the experiment. 4. Knee movement injury: combined IRR of 0.73 (95% CI2 0.63-0.84); Z = 4.44;P< 0.00001). The female group had a higher risk of loss compared to the male group in the experiment. 5. Ankle sports injury: combined IRR of 0.54 (95% CI2 0.40-0.74); Z = 3.90;P< 0.00001). The male group had a higher risk of loss compared to females in the experiment. 6. Acute sports injury: The combined IRR is 0.60 (95% CI2 0.49-0.74); Z = 4.84;P< 0.00001), The male group had a similar reduced risk of loss compared to females in the experiment. 7. Chronic sports injury: The combined IRR was 0.72 (95% CI2 0.52-0.98; Z=2.07; P=0.04), and the female group had a higher risk of loss compared to males in the trial. Conclusion: Neuromuscular training has significant effects in preventing upper and lower limbs, knees, ankles, and acute and chronic sports injuries of different genders. Research has shown that neuromuscular training has similar effects on different genders, effectively reducing the burden of public health and promoting participation in sports activities. However, more high-quality randomized controlled trials are still needed to further validate these findings.

Introduction: While anterior cruciate ligament (ACL) tears are commonly managed with ACL reconstruction (ACL-R), 35% of ACL-R individuals fail to return to the preinjury elite sport level. Persistent neuromuscular deficits in the hamstrings and quadriceps have been observed. It has been proposed that aquatic therapy can be used to optimize neuromuscular control after ACL-R. Objectives: (1) To compare muscle activity in ACL-R individuals during aquatic treadmill (ATM) running at different water depths and (2) to compare muscle activity during ATM running between ACL-R and healthy individuals. Methods: A total of 38 participants, including 18 ACL-R individuals (mean postoperative time [SD] = 25.8 [25.0] mo) and 20 healthy individuals were recruited. Muscle activity of biceps femoris (BF), rectus femoris (RF), tibialis anterior, and medial gastrocnemius during land treadmill and ATM running at mid-shin, mid-thigh, and waist levels were recorded using surface electromyography (sEMG). The sEMG signals of the selected muscles were normalized and expressed in % Maximal Voluntary Contraction (%MVC). Muscle activity of the ACL-R, ACL-contralateral, and healthy control limbs at different water depths was compared. Results: Among the 3 groups, the ACL-R group demonstrated the most prominent percentage increase of 101.97% (P = .001) at mid-shin level, 139.66% (P = .001) at mid-thigh level, and 141.97% (P < .001) at waist level, respectively, in %MVC when compared to land. In the ACL-R group, muscle activity of BF in the stance phase (BFSt) was significantly higher than the control group on land at all water depths. Muscle activity of RF in the swing phase (RFSw) in the ACL-R group significantly increased in all water depths immersion when compared to land, respectively. Conclusion: This study showed an increasing trend in muscle activity of BFSt and RFSw in ACL-R individuals during ATM running at increased water depths. ATM running could be implemented as neuromuscular training in rehabilitation after ACL-R. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the effect of motivational interviewing (MI) and mindfulness (MF) added to neuromuscular (NM) exercises on improving pain, function, balance, and quality of life in patients with knee osteoarthritis (KOA). This randomized clinical trial was conducted on sixty patients who were randomly assigned to the MI + NM, MF + NM, and NM groups. The groups received four training sessions for six weeks. Physical function with Western Ontario and McMaster Universities Arthritis Index timed up and go, going up and down eight stairs, pain with visual analogue scale, quality of life with SF36, and balance with Biodex were evaluated before and after interventions. Within-group comparisons showed that NM + MI, NM + MF, and NM groups experienced significant improvement in all factors after six-week (p < 0.05). However, between groups, comparisons in the post-test revealed that the MI + NM group had a more significant effect on pain, function, and static balance than the MF + NM group. Nevertheless, the MF + NM group improved the quality of life better than the MI + NM and NM groups (p < 0.05). Adding psychological interventions to physical exercises had a better effect on improving the symptoms of patients. Additionally, the MI showed more effectiveness in improving the symptoms of patients. Adding motivational interviewing to neuromuscular exercises has shown to reduce pain intensity and improved function, balance and quality of life in adults with knee osteoarthritis. Adding mindfulness intervention to neuromuscular exercises has shown to reduce pain intensity and improved function, balance and quality of life in adults with knee osteoarthritis. Among the psychological interventions used, the motivational interviewing significantly showed more effectiveness in improving the pain, function, balance, and quality of life of patients with osteoarthritis. [ABSTRACT FROM AUTHOR]

Knowledge is limited regarding how neuromuscular training, conducted before and after soccer training, affects the fitness levels of youth soccer players. In this study, we aimed to analyze the effects of an eight-week neuromuscular training (NMT) program implemented before or after a soccer session on physical fitness in youth soccer players. Thirty-two youth soccer players were categorized into two groups—namely, NMT before soccer-specific training (NBS; n = 15) and NMT after soccer-specific training (NAS; n = 17). NMT comprised integrated resistance, dynamic stability, core, and plyometric training three times weekly and was conducted for 8 weeks. Before and after the exercise intervention, the counter-movement jump (CMJ) and 10 and 20 m sprint were analyzed, and the results of the T-agility test, Illinois change of direction test (ICDT), and Y-balance test were assessed for all participants. In terms of the interaction between the effects of the time of observation and group, both groups showed improvement in the results of the 10 m sprint and T-agility and Y-balance tests. Regarding the difference in the time of observation, the NBS group showed positive improvements in the results of the CMJ, 10 and 20 m sprints, and T-agility test after the exercise intervention, and the NAS group showed positive improvements in the results of the CMJ, 10 m sprint, T-agility test, and ICDT after the exercise intervention. These findings suggest that neuromuscular training has the potential to improve the 10 m sprint ability and T-agility test results of youth soccer players, regardless of the training sequence. [ABSTRACT FROM AUTHOR]

Background: Aging causes morphological and physiological changes, especially in the musculoskeletal and somatosensory systems, leading to sarcopenia and reduced postural balance, increasing the risk of falls and loss of independence. This study aimed to analyze the effects of a neuromuscular training program on postural balance, physical performance, and muscle strength in older Chilean women. Methods: The double-blind randomized controlled trial included 48 participants aged 65–80 who were divided into three groups: a control group (CG), a multicomponent training group (MCG), and a neuromuscular training group (NMG). Postural balance was assessed using a force platform with open eyes (OE) and closed eyes (CE) conditions, measuring ML velocity, AP velocity, mean radius, and area. Physical performance was evaluated with the Short Physical Performance Battery (SPPB), including static balance, 4-m walking speed, and 5× sit-to-stand chair test. Muscle strength was measured using a hydraulic hand dynamometer to record maximum grip force. Results: Significant time × group interactions in the CE condition were found for mean radius (F = 0.984; p = 0.017; ηp2 = 0.184), AP velocity (F = 10.01; p = 0.001; ηp2 = 0.312), and ML velocity (F = 4.30; p = 0.027; ηp2 = 0.163). Significant pre–post differences in the NMG for mean radius (p < 0.001), AP velocity (p < 0.001), and ML velocity (p = 0.029) were observed, with no significant changes in CG. Significant time × group interactions were also found in the SPPB test score (F = 11.49; p < 0.001; ηp2 = 0.343), gait speed (F = 5.513; p = 0.012; ηp2 = 0.198), and sit-to-stand test (F = 5.731; p = 0.010; ηp2 = 0.206), but not in the balance score (F = 2.099; p = 0.148). Handgrip strength showed no significant interactions (F = 3.216; p = 0.061; ηp2 = 0.127). Conclusions: These findings suggest that neuromuscular training is a promising intervention to mitigate the decline in balance and physical function associated with aging, offering a targeted approach to improve the quality of life in the elderly.

Introduction: The aim of anterior cruciate ligament injury prevention programs is to correct or eliminate risk factors and ultimately reduce injury. The present study aimed to investigate the effect of neuromuscular exercises on knee and ankle joint proprioception in male soccer player students prone to anterior cruciate ligament injury. Material & Methods: In this quasi-experimental research, 24 male soccer players prone to anterior cruciate ligament injury at Khorazmi University of Tehran in 2018 were purposefully selected and randomly assigned to two experimental groups (n=12) and control groups (n=12). Two days before the commencement of neuromuscular training, knee and ankle proprioception assessment was performed on all subjects. The members of the experimental group participated in the neuromuscular training program for six weeks (3 sessions per week). Two days after finishing the training, all subjects were re-evaluated. Data were analyzed in SPSS software (version 22) using Shapiro-Wilk, covariance, and paired t-tests. Findings: In this study, among 24 students prone to anterior cruciate ligament injury, 12 cases performed neuromuscular training for six weeks. The results demonstrated that knee proprioception (P=0.013) and ankle proprioception (in inversion movement p=0.032, in eversion movement P=0.047) in the experimental group improved significantly after six weeks of neuromuscular training compared to the control group (P≤0.05). Discussion & Conclusion: As evidenced by the obtained results, the use of neuromuscular training can be recommended to improve the proprioception of the knee and ankle joints and ultimately prevent anterior cruciate ligament injury.

Neuromuscular training warm-up programs can reduce injury rates in youth sports, but they often have poor uptake and adherence. Delivering such programs in school physical education classes may provide greater public health benefit, particularly if they promote improved injury knowledge and prevention beliefs amongst students. The purpose of this secondary analysis of a large cluster-randomized controlled trial was to understand how students' (age 11–15 years) knowledge and beliefs change after exposure to an evidence-informed neuromuscular training warm-up program. Six schools delivered the program for a 12-week period in the initial study year (n=566) and two continued to use it in a subsequent "maintenance" year (n=255). Students completed a knowledge and beliefs questionnaire at baseline, 6-week, and 12-week timepoints. Knowledge scores ranged from 7/10 to 8/10 at all timepoints and students generally believed that injuries are preventable. On average, there was less than a one-point change in knowledge between timepoints and there was no change in the median belief scores. There were no meaningful differences between sexes, grades, or previous injury. These findings highlight that knowledge and beliefs are unlikely to change passively through program exposure. More active strategies are needed to improve injury prevention perceptions in this population. [ABSTRACT FROM AUTHOR]

Background: Ankle sprains are frequent injuries in general practice. However, no effective treatment is available yet. Aim: To examine the effectiveness of an unsupervised e-health-supported neuromuscular training programme in combination with usual care compared with usual care alone in patients with acute lateral ankle sprains in general practice. Design and setting: Randomised controlled trial with 1-year follow-up among patients (14–65 years) who visited the GP with an acute lateral ankle sprain within 3 weeks of injury. Method: The intervention group received, in addition to usual care, an unsupervised e-health-supported neuromuscular training programme and the control group received usual care alone. The primary outcome was self-reported re-sprains during 52 weeks of follow-up. Secondary outcomes were ankle function, pain in rest and during activity, subjective recovery, and return to the same type and level of sport. Results: In total, 165 participants (mean age 38.3 years and 69 [41.8%] male) were included. No statistically significant difference in the occurrence of a re-sprain were found between the intervention 20.7% (17/82) and control group 24.1% (20/83) (hazard ratio 1.14, 95% confidence interval = 0.59 to 2.21). Also, no statistically significant differences in secondary outcomes were found between groups. The adherence rate to the programme was low (6.1%, 5/82). Conclusion: The rate of re-sprains was relatively high and an unsupervised e-health-supported neuromuscular training programme does not yield meaningful effects and does not encourage adherence in preventing re-sprains in patients in general practice. More research is necessary to indicate the best treatment modality and way of delivery for these patients. [ABSTRACT FROM AUTHOR]

Abstract Background Injury prevention exercise programmes (IPEPs) efficaciously reduce injuries. However, it is challenging to achieve sufficient adherence across a season. The main aim was to describe adherence to IPEPs in three groups of coaches and players partaking in a cluster randomised trial. Secondary aims were to describe perceptions of IPEPs, use of programme material, and overall preventive strategies. Methods This is a sub-study analysing data from a three-armed randomised trial with teams randomised to use either a comprehensive IPEP (extended Knee Control) or an adductor strength programme, and non-randomised teams that already used a self-chosen IPEP regularly at study start (comparison group). Teams were instructed to use their respective intervention across the 2020 football season. Male and female, adolescent (≥ 14 years of age), and adult amateur players took part. Coaches and players responded to weekly and end-of-season questionnaires. Data were presented descriptively. Results Weekly player data were reported by 502 players (weekly response rate 65%), 289 (58%) responded to end-of-season questionnaires. Teams in the extended Knee Control and comparison group used their respective IPEP in 483/529 (91%) and 585/641 (91%) of training sessions, and teams in the adductor group in in 199/315 (63%) sessions. Regarding utilisation fidelity, 42–52% of players in each group used 1–10 repetitions per exercise. Seven out of 17 teams in the adductor group had progressed as recommended in terms of number of repetitions. Two teams (10%) in the extended Knee Control group, and 7/24 of comparison teams used the same exercises across the season. Coaches accessed the IPEPs by different means (printed material, films, workshops, etc.), but half did not use the provided digital material. The players appreciated that the IPEPs could reduce injury risk and that they improved their exercise performance, but disliked that they had less time for football and that the exercises were boring. Forty-nine players had experienced pain during IPEP performance. Conclusions Adherence with the IPEPs was generally high. To meet different coach needs, programme material should be available via different digital and printed resources. The number of players reporting pain during IPEP performance is a noteworthy finding. Trial registration Clinical Trials gov identifier: NCT04272047. Registered February 17, 2020. https://clinicaltrials.gov/ct2/show/NCT04272047 .

Background and Aims The present study aims to investigate the effect of a neuromuscular training program on knee valgus angle, and range of motion (ROM) and muscle strength of hip and ankle in male adolescent football players with dynamic knee valgus (DKV). Valgus knee is one of the most common neuromuscular abnormalities that is involved in causing non-contact damage to the anterior cruciate ligament (ACL).Methods This is a quasi-experimental study. Participants were 25 adolescent male football players with DKV who were purposefully selected from Shahin Football Academy in Amol, Iran and randomly divided into two groups of control and training. The existence of DKV was assessed by Squats test and the valgus angle were assessed by jump-landing test and Kinovea software. The abduction and external rotation strength and ROM of hip and the dorsiflexion and plantarflexion strength and ROM of ankle were evaluated with Manual Muscle Testing and a goniometer, respectively. After performing the pre-test assessments, the subjects in the training group performed neuromuscular training for 8 weeks, while the control group also participated in the physical fitness program of Shahin Football Academy. At the end, assessments were performed again in two groups. To examine the differences, repeated measures analysis of variance and Bonferroni post hoc test were used in SPSS software, version 24. The significance level was set at 0.05. Results The results showed a significant difference in knee valgus angle (P=0.001), abduction ROM of hip (P=0.01), external rotation ROM of hip (P=0.01), dorsiflexion ROM of ankle with knee extension (P=0.001), dorsiflexion ROM of ankle with knee flexion (P=0.001), hip abduction strength (P=0.002), hip external rotation strength (P=0.01), and plantarflexion strength of ankle (P=0.03) between the control and training groups. However, the results showed no significant difference in plantarflexion ROM of ankle and dorsiflexion strength of ankle (P>0.05). After one month, the results showed the sustainability of the effect of training on abduction and external rotation ROM of hip, dorsiflexion ROM of ankle with knee extension and flexion, and dorsiflexion and plantarflexion strength of ankle.Conclusion The neuromuscular training can reduce the risk of non-contact ACL injury in male football players with DKV by improving strength and ROM of hip and ankle.

The purpose of this review is to assess available literature in relation to the effectiveness of therapeutic exercise in preventing medial tibial stress syndrome and navicular drop in active populations. This review contains primary research articles which adhered to the following inclusion criteria: randomised controlled trials, sample populations at risk of medial tibial stress syndrome, includes therapeutic exercise intervention, outcomes measuring medial tibial stress syndrome incidence or navicular drop. Exclusion criteria: combined therapeutic exercise with other therapeutic modalities, included participants with pre-existing symptomatic medial tibial stress syndrome or other lower limb injuries. Databases used included: CINAHL Complete, Scopus, EmCare (Ovid), Medline (Ovid), PubMed and SPORTDiscus. PEDro scale and NHMRC levels of evidence were used to assess methodological quality and risk of bias. Nine articles met eligibility criteria for review and were appraised for methodological quality. Moderate to high methodological quality was reported for the included studies. Six studies reported significant reductions in medial tibial stress syndrome risk or navicular drop when exposed to therapeutic exercise interventions. Effective interventions included intrinsic foot muscle, gluteal and lower leg strengthening as well as balance, plyometric and flexibility exercises. Three studies reported no significant effect of therapeutic exercise on medial tibial stress syndrome or navicular drop when compared to controlled interventions. Findings for therapeutic exercise in the prevention of medial tibial stress syndrome and correction of navicular drop are promising and provide basis for its practical application; however, the quality of the available literature limits the generalisability of outcomes. Further research needs to be conducted into the effectiveness of therapeutic exercise in medial tibial stress syndrome prevention. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to compare the effect of flexi-bar and stabilization exercises on static and dynamic postural control in patients with chronic nonspecific low back pain. Patients and methods: In this randomized controlled study conducted between November 2019 and March 2020, 38 patients (19 males, 19 females; mean age: 33.8±6.2 years; range, 20 to 45 years) were randomly assigned into flexi-bar (n=19) and stabilization (n=19) groups. Both groups received general physiotherapy for three sessions per week, a total of 10 sessions. Besides, the flexi-bar group received flexi-bar exercises, and the stabilization group received stabilization exercises. Postural sway was assessed with a force platform in three difficult conditions, including open eye, close eye, and one-leg standing and dynamic posture with the modified Star Excursion Balance Test. Results: After the intervention, both groups showed a significant improvement in static and dynamic postural control (p<0.05). However, no significant differences were found between groups after treatment, while only the phase-plane portrait of opened eyes condition was significantly improved (p=0.03), in the flexi-bar group compared to the stabilization group. Conclusion: Both flexi-bar and stabilization exercises effectively improved static and dynamic postural control, but none of the exercises was superior to the other. Flexi-bar is recommended as an effective tool in low back pain rehabilitation. [ABSTRACT FROM AUTHOR]

To investigate the effects of neuromuscular training, with minimal or no equipment, on physical performance of youth athletes. Systematic review with meta-analysis. MEDLINE, EMBASE, CENTRAL, CINAHL, PEDro and SportDiscuss from inception to March/2022. Selection Criteria: youth athletes (15–24years), from Olympic team sports; used neuromuscular training 2–3 times/week for, at least, 6 weeks; had a control group/usual training group; physical performance as outcomes; randomized controlled trial. Data Synthesis: Pooled estimate of standardized mean difference (SMD), and 95% confidence interval (95%CI). Thirty-four studies (1111 participants) were included. Results showed that neuromuscular training improved power (SMD: 0.84 [95%CI: 0.58, 1.10]; n = 805; I2 = 64%), speed (SMD: −1.12 [95%CI: −1.68, −0.57]; n = 688; I2 = 90%) and agility (SMD: −1.21 [95%CI: −1.60, −0.83]; n = 571; I2 = 76%) compared to control group, but showed no difference between groups for muscle strength (Quadriceps SMD: 0.34 [95%CI: −0.02, 0.69]; n = 132; I2 = 0%, Hamstrings: SMD: 0.64 [95%CI: −0.04, 1.33]; n = 132; I2 = 71%), balance and flexibility. Clinically, neuromuscular training with minimal equipment may be useful for teams with limited resources to improve mainly athletes' power and agility, including those interventions that were designed to injury prevention. Future high-quality studies are likely to change these estimates. • No equipment training may improve power, speed and agility in youth athletes. • There was no difference between groups for balance, strength and flexibility. • Health professionals and teams with low resources may benefit from those findings. • No equipment intervention may help athlete's adherence to training. • Intervention may offer a dual benefit on performance and injury prevention. [ABSTRACT FROM AUTHOR]

Real-time biofeedback (Rt-Bf) has gained substantial recognition in recent years as an invaluable tool in the fields of rehabilitation and sports medicine. Its application has piqued the interest of professionals across a wide spectrum of sports settings, making it a pivotal focus of research. The primary objective of this study was to investigate how the integration of biofeedback into training programs could impact the vertical jump and balance outcomes in healthy subjects, in direct comparison to traditional approaches such as verbal instructions (VER) and video observation (VO). A total of 262 active healthy subjects were randomized into three groups: VER, VER + VO, and VER + Rt-Bf. The subjects underwent a vertical jump test (squat jump) and a balance test (single-leg squat) following a pre-established protocol. After a 5-min rest period, the tests were repeated. During the rest period, each group received specific interventions: VER group received verbal instructions, VO group watched a video execution, and Rt-Bf group received real-time biofeedback. Gyko® technology was employed as the measuring tool, capturing and analyzing all relevant parameters associated with both the jump and balance protocols. The Rt-Bf group exhibited a significantly higher improvement in jump height (2.3 cm) compared to the other groups (p < 0.001). While the Rt-Bf group also demonstrated enhancements in various parameters of the single-leg squat, these improvements were not statistically significant (p > 0.05). The findings suggest that incorporating an Rt-Bf protocol alongside VER significantly enhances vertical jump performance. Although balance parameter improvements were also observed in the Rt-Bf group, they did not reach statistical significance (p > 0.05). These findings reaffirm the pivotal role that Rt-Bf plays in augmenting physical performance in healthy individuals, offering a promising avenue for future research and application. [ABSTRACT FROM AUTHOR]

Background: Anterior cruciate ligament (ACL) tear is a common medical condition that entails a stretch or sprain of the ACL, which is present in the knee joint. The incidence of ACL injury in the Kingdom of Saudi Arabia is estimated to be 31.4%. Prevention training programs (PTPs) can be used to reduce ACL injuries sustained during physical activity, as they primarily focus on improving strength, balance, and lower limb biomechanics and reducing landing impact. This study aimed to assess Saudi athletes’ awareness of ACL injury PTPs. Methods: A cross-sectional survey in the form of a self-administered questionnaire in the Arabic language was carried out from 22 December 2022 to 7 March 2023 and included 1169 Saudi athletes. Statistical analyses were performed on the collected data using frequency and percentages. Binary logistic regression was used for the adjusted analysis and determining associations between athletes playing high- and low-risk sports. Results: Overall, 52% of participants were female athletes, and 48% were male athletes. The western region of the country had the highest response rate (28.9%). The most common sport played was football at 36.6%. Most participants (70.97%) reported that their information on ACL injury was taken by their coaches. When assessing whether participants were familiar with the concept of an ACL injury PTP, the majority of the participants answered no, representing 971 (662 high-risk, 309 low-risk), compared to those who answered yes, representing only 198 (167 high-risk, 31 low-risk), with a statistically significant difference (adjusted OR: 2.106; 95% confidence interval: 1.544–2.873; p-value < 0.001). Conclusion: In general, the level of awareness of ACL injury PTPs among Saudi athletes was poor.

Abstract Background Youth participation in team ball sports is associated with a risk of both acute and gradual onset injuries but today there are several efficacious injury prevention exercise programmes (IPEPs). However, there is limited research about how to implement those programmes and the perceived barriers and facilitators among end-users. Objective To investigate perceptions of the IPEP Knee Control and facilitators and barriers to programme use among coaches and youth floorball players, and explore factors associated with planned maintenance of Knee Control. Methods This cross-sectional study is a sub-analysis of data from the intervention group of a cluster randomised controlled trial. Perceptions about Knee Control and facilitators and barriers to programme use were evaluated with surveys pre-intervention and post-season. 246 youth floorball players aged 12–17 years, and 35 coaches that reported no use of IPEPs during the preceding year were included. Descriptive statistics and univariate and multivariate ordinal logistic regression models were undertaken with the dependent variables: coaches’ planned maintenance and players’ opinions of maintenance of Knee Control. Independent variables were perceptions, facilitators and barriers regarding use of Knee Control and other potential influencing factors. Results 88% of the players believed that Knee Control can reduce injury risk. Common facilitators to Knee Control use among coaches were support, education and high player motivation, and common barriers were that injury prevention training was time-consuming, lack of space to execute the exercises and lack of player motivation. Players who planned to maintain use of Knee Control had higher outcome expectancies and belief in one’s ability to use Knee Control (action self-efficacy). Coaches who planned to maintain Knee Control had higher action self-efficacy and to a lesser extent considered that Knee Control takes too much time. Conclusions Support, education, and high player motivation are key facilitators, while lack of time and space for injury prevention training and boring exercises are key barriers for coaches and players to use Knee Control. High action self-efficacy among coaches and players seems to be a prerequisite for maintained use of IPEPs.

Abstract Background Previously, researchers reported performance enhancements following long-term plyometric training in athletes with anterior cruciate ligament reconstruction (LCA). However, the effects of combined eccentric and plyometric training on measures of isokinetic strength and psychological statues in male athletes have not been examined yet. Knowledge on the effects of combined eccentric and plyometric training help to better plan and program rehabilitations sessions and thus return-to-sports. Objective This study sought to compare the effects of three different rehabilitation training programs, eccentric training (ECC), plyometric training (PLYO), or combined eccentric and plyometric training (COMB), on psychological measures (kinesiophobia [TSK-CF], functional knee assessment, knee injury and osteoarthritis outcome score [KOOS], international knee documentation committee 2000 questionnaire [IKDC], and knee flexor and extensor isokinetic muscle performance (peak torque [PT], total work, ratio [R-HQ], and ratio of total work [R-TW]) at different angular velocities post ACL surgery in male elite athletes. Methods Forty elite male athletes from different sports (e.g., athletics, team sports) with ACL reconstruction participated in this study. The study started after a 14-weeks post-surgery rehabilitation program, which was identical for all subjects. After this initial rehabilitation period, athletes were randomly assigned to three experimental groups, ECC (n = 10), PLYO (n = 10), and COMB (n = 10), and a control group (CON: n = 10). Testing was conducted pre- and post-the 6-weeks intervention period and included the TSK-CF, KOOS, and IKDC. Peak torque of the knee extensors/flexors was tested at 90, 180, 240 °/s, after the 6-weeks training program only. Results Participants’ adherence rate was 100% across all groups and none reported any training or test-related injury. No significant between-group baseline differences (pre-6-weeks intervention) were observed for any of the reported psychological and muscle strength parameters. Significant group-by-time interactions were found for TSK-CF (p = 0.001, d = 2.85), KOOS (p = 0.001, d = 1.31), and IKDC (p = 0.001, d = 1.07). The post-hoc analyses indicated that COMB showed larger pre-post improvements for all psychological variables (p

The aim of this research was effect of eight weeks of neuromuscular training (NMT) with and without cognitive-dual tasks (DTs) on proprioception and balance of athletes with ACL deficiency (ACL-D). 39 soccer players with ACL-D were selected purposefully and randomly divided into three groups of 13 (control group, neuromuscular training group and neuromuscular training with dual tasks group). Two training groups performed the exercises for eight weeks and three sessions per week. cognitive-motor dual tasks were performed in one of the groups along with neuromuscular exercises in the form of counting down numbers, memorizing numbers, calculating unexpected equations, specialized football skill movements. The results of the current study indicated that there was no significant difference in knee joint proprioception in the open and closed kinetic chain after applying the intervention between the three groups, but there was a significant difference in lower extremity performance of the athletes based on the Y balance test in the anterior and posterior-lateral direction between the three groups (p<0.05). It seems that providing neuromuscular exercises along with cognitive-dual tasks can probably be considered as a useful approach to improve lower extremity performance based on the Y balance test in athletes with anterior cruciate ligament deficiency. [ABSTRACT FROM AUTHOR]

Balance requires constant adjustments in muscle activation to attain force steadiness. Creating appropriate training can be challenging. The purpose of this study was to examine the effects of 2 weeks of front squat instability training using a water-filled training tube on force steadiness during an instability challenge. Control (CON, n = 13) and experimental (EXP, n = 17) subjects completed pre- and post-testing for EMG variability by completing one set of 10 repetitions with a stable and unstable training tube. Electrodes were placed bilaterally on the anterior deltoid, paraspinal, and vastus lateralis muscles. CON subjects completed 2 weeks of training using a stable training tube, while EXP subjects trained with a water-filled instability tube. EMG data were integrated for each contraction, and force steadiness was computed using the natural log of coefficient of variation. CON results showed no changes in force steadiness for any condition. EXP showed significant reductions in EMG activation variability across all muscles. These results indicate a significant training effect in reducing muscle activation variability in subjects training with a water-filled instability training device. Improvements seen in these healthy subjects support the development of training implements for a more clinical population to help improve force steadiness. [ABSTRACT FROM AUTHOR]

Aim: The aim of this paper is to determine the effect of 6 weeks of plyometric training on speed, explosive power, pre-planned agility, and reactive agility in young tennis players. Methods: The participants in this study included 35 male tennis players (age 12.14 ± 1.3 years, height 157.35 ± 9.53 cm and body mass 45.84 ± 8.43 kg at the beginning of the experiment). The biological age was calculated and determined for all participants. 18 of the participants were randomly assigned to the control group, and 17 were assigned to the experimental group. Running speed (sprints at 5, 10, and 20 m), change of direction speed (4 × 10, 20 yards, t-test, TENCODS), reactive agility (TENRAG), and explosive power (long jump, single leg triple jump, countermovement jump, squat jump, and single leg countermovement jump) were all tested. The Mixed model (2 × 2) ANOVA was used to determine the interactions and influence of a training program on test results. Furthermore, Bonferroni post hoc test was performed on variables with significant time*group interactions. Results: The results of this research indicate that an experimental training program affected results in a set time period, i.e. 5 out of total 15 variables showed significant improvement after experimental protocol when final testing was conducted. The experimental group showed significantly improved results in the 5 m sprint test in the final testing phase compared to the initial testing phase, this was also the case in comparison to the control group in both measurements. Furthermore, the experimental group showed significant improvement in the single leg countermovement jump in the final test, as well as in comparison to the control group in both measurements. The change of direction speed and reactive agility test also exhibited significant improvement in the final testing phase of the experimental group. Conclusion: The results of this research indicated that a 6-week program dominated by plyometric training can have a significant effect on the improvement of specific motor abilities within younger competitive categories. These results offer valuable insights for coaches in designing diverse tennis-specific scenarios to enhance overall performance, particularly focusing on the neuromuscular fitness of their players. [ABSTRACT FROM AUTHOR]

Sensorimotor dysfunction is one of the factors leading to advancement of knee osteoarthritis (OA). Limited evidence supports the use of neuromuscular training (NMT) incorporating all the elements of sensorimotor function viz. strength, balance, coordination, and proprioception, hence the current study aimed to evaluate the efficacy of NMT integrating all aspects of sensorimotor function on pain, function, and balance in patients with knee OA. This single-blinded RCT recruited 62 subjects (40–65 years) with KL grade II-III of knee OA, who were randomly allocated into two groups namely NMT or strengthening group (twice a week for 6 weeks). Outcomes were assessed for pain (NPRS), function (CRD version of WOMAC, PSFS, chair stand test, stair climb test, timed up and go test), and balance (Y-balance) at baseline and at the completion of the intervention. 54 subjects completed the trial. Although both groups had significant improvement NMT was more effective (p value < 0.05) for most clinical outcomes of NPRS, Y-balance, and WOMAC with low-moderate effect size and objective functional tests – chair stand test and timed up and go test. NMT was more effective in improving the clinical outcomes of pain, function (except PSFS), and balance in subjects with KL grade II-III knee OA. Knee OA patients may benefit with addition of NMT to their intervention. However, due to limitations of low effect size, the results should be considered with caution. [ABSTRACT FROM AUTHOR]

Background: Injury prevention exercise programmes (IPEPs) efficaciously reduce injuries. However, it is challenging to achieve sufficient adherence across a season. The main aim was to describe adherence to IPEPs in three groups of coaches and players partaking in a cluster randomised trial. Secondary aims were to describe perceptions of IPEPs, use of programme material, and overall preventive strategies. Methods: This is a sub-study analysing data from a three-armed randomised trial with teams randomised to use either a comprehensive IPEP (extended Knee Control) or an adductor strength programme, and non-randomised teams that already used a self-chosen IPEP regularly at study start (comparison group). Teams were instructed to use their respective intervention across the 2020 football season. Male and female, adolescent (≥ 14 years of age), and adult amateur players took part. Coaches and players responded to weekly and end-of-season questionnaires. Data were presented descriptively. Results: Weekly player data were reported by 502 players (weekly response rate 65%), 289 (58%) responded to end-of-season questionnaires. Teams in the extended Knee Control and comparison group used their respective IPEP in 483/529 (91%) and 585/641 (91%) of training sessions, and teams in the adductor group in in 199/315 (63%) sessions. Regarding utilisation fidelity, 42–52% of players in each group used 1–10 repetitions per exercise. Seven out of 17 teams in the adductor group had progressed as recommended in terms of number of repetitions. Two teams (10%) in the extended Knee Control group, and 7/24 of comparison teams used the same exercises across the season. Coaches accessed the IPEPs by different means (printed material, films, workshops, etc.), but half did not use the provided digital material. The players appreciated that the IPEPs could reduce injury risk and that they improved their exercise performance, but disliked that they had less time for football and that the exercises were boring. Forty-nine players had experienced pain during IPEP performance. Conclusions: Adherence with the IPEPs was generally high. To meet different coach needs, programme material should be available via different digital and printed resources. The number of players reporting pain during IPEP performance is a noteworthy finding. Trial registration: Clinical Trials gov identifier: NCT04272047. Registered February 17, 2020. https://clinicaltrials.gov/ct2/show/NCT04272047. [ABSTRACT FROM AUTHOR]

Introduction: The aim of anterior cruciate ligament injury prevention programs is to correct or eliminate risk factors and ultimately reduce injury. The present study aimed to investigate the effect of neuromuscular exercises on knee and ankle joint proprioception in male soccer player students prone to anterior cruciate ligament injury. Material & Methods: In this quasi-experimental research, 24 male soccer players prone to anterior cruciate ligament injury at Khorazmi University of Tehran in 2018 were purposefully selected and randomly assigned to two experimental groups (n=12) and control groups (n=12). Two days before the commencement of neuromuscular training, knee and ankle proprioception assessment was performed on all subjects. The members of the experimental group participated in the neuromuscular training program for six weeks (3 sessions per week). Two days after finishing the training, all subjects were re-evaluated. Data were analyzed in SPSS software (version 22) using Shapiro-Wilk, covariance, and paired t-tests. Findings: In this study, among 24 students prone to anterior cruciate ligament injury, 12 cases performed neuromuscular training for six weeks. The results demonstrated that knee proprioception (P=0.013) and ankle proprioception (in inversion movement p=0.032, in eversion movement P=0.047) in the experimental group improved significantly after six weeks of neuromuscular training compared to the control group (P≤0.05). Discussion & Conclusion: As evidenced by the obtained results, the use of neuromuscular training can be recommended to improve the proprioception of the knee and ankle joints and ultimately prevent anterior cruciate ligament injury. [ABSTRACT FROM AUTHOR]

Peripheral nerve disorder of the lower extremities causes drop foot and disturbs the daily living activities of patients. The ankle joint hybrid assistive limb (HAL) provides voluntary ankle joint training using surface bioelectrical signals from the muscles of the lower extremities. We investigated the neurological effects of ankle joint HAL training in three patients. Sensory nerve action potentials (SNAPs) and compound muscle action potentials (CMAPs) were analyzed for the peroneal and tibial nerves prior to the first ankle joint HAL training session. Integrated surface electromyography EMG signals were recorded before and after the HAL training sessions to evaluate the effects of training for neuromuscular disorders. The patients were hospitalized to receive rehabilitation with HAL training for 2 weeks. The HAL training was performed daily with two 60 min sessions. All cases demonstrated severe neuromuscular impairment according to the result of the CMAP. All integrated EMG measurements of antagonistic muscle activities decreased after the ankle joint HAL training. The manual muscle testing (MMT) scores of each muscle were slightly increased after the HAL intervention for Case 2(tibialis anterior, from 2 to 2+; gastrocnemius muscles, from 2− to 2; extensor digitorum longus, and extensor hallucis longus, from 1 to 3). The MMT scores were also slightly increased except for gastrocnemius muscle for Case 3 (tibialis anterior, extensor digitorum longus, and extensor hallucis longus, from 2− to 2). These two patients demonstrated voluntary muscle contractions and nerve signals in the CMAP before the HAL training. Even though the amplitude of CMAPs was low, the HAL training may provide voluntary ankle joint movements by reducing the antagonistic muscle contraction via computer processing. The HAL training may enhance muscle movement and coordination through motor learning feedback. [ABSTRACT FROM AUTHOR]

Background: Both of transcranial direct current electrical stimulation (tDCS) and neuromuscular training (NMT) have used to relive motor deficits in neurological disease. Aim: We decided to investigate augmenting effect of tDCS and NMT to improve static and dynamic balance and gait parameter in autism spectrum disorder (ASD). Materials and Methods: 24 children with ASD aged 6-10 years old were randomly assigned to one of three groups: NMT+ sham, anodal tDCS, and NMT + tDCS. NMT consisted of 10 sessions motor training (each for 40 min). tDCS training was performed with 1.5 mA on left primary motor cortex for 20 min. Pre-test and post-test evaluations included static and dynamic balance and gait parameters (length and width of stepping and speed of gait). Results: Although improvement of variables were seen in all groups, but in post intervention comparison, combined group was better in static and dynamic balance and gait parameters than two other groups. NMT was more effective than tDCS only in dynamic balance. Conclusion: Our findings were indicated tDCS enhance NMT effect on neuromuscular function in ASD, so regarding the augmented effect in combination of NMT and tDCS, it can be considered in rehabilitation of motor deficits in these children. [ABSTRACT FROM AUTHOR]